Good Self-care Research Articles

The trajectory of self-care over a 12-month period in patients with heart failure, comparing those with consistently good and poor self-care

Abstract Background Self-care behaviour plays a pivotal role in enhancing the quality of life for patients with heart failure (HF) and reducing mortality and morbidity rates, but many patients struggle with suboptimal self-care behaviours. It is crucial to understand the factors influencing long-term self-care management. Purpose To assess the trajectory of self-care over a 12-month period and assess differences between patients who have constantly good self-care over a 12-month period compared to constantly poor self-care. Method This study use data from a randomised controlled intervention study, called the HF-Wii study. We included patients who had complete data on self-care during on baseline, 3, 6 and 12 months. Self-care was measured with the European Heart Failure Self-care Behaviour scale (EHFSBs). A threshold score of equal or higher than 70 was used to define self-care behaviour as good and a score lower than 70 as poor self-care. Based on literature, the following characteristics (collected from questionnaires and medical records at baseline) were considered in the analysis: age, sex, marital status, education, history of myocardial infarction, duration of HF, New York Heart Association (NYHA) functional class, LVEF, comorbidity. Other factors assessed were Health-related Quality of Life (HrQoL, Minnesota living with HF questionnaire), depressive symptoms (Hospital Anxiety and Depression scale), cognition (Montreal Cognitive Assessment), sleep (Minimal Insomnia Symptom Scale) and level of HF knowledge (Dutch HF knowledge scale). Logistic regression was performed with backwards elimination of the factors considered associated with the differences between patients who have constantly good self-care at baseline, 3, 6 and 12 months compared to constantly poor self-care. Results In total, 407 patients were included in this study. At baseline, the mean self-care was 65±21, with 41% of the patients (n=245) performing good self-care. In total, 126 patients had a constantly good self-care over 12 month (31%), 120 patients had a constantly bad self-care over 12 months (30%) and 161 (39%) fluctuated in their self-care (Figure). In the multivariate analysis, patients that had continuously good self-care over 12-months were of older age (68±10 vs. 64±12, odds ratio (OR) 1.061, P-value<0.001), had higher HF knowledge (score 13±2 vs. 12±2, OR 1.439, P-value<0.001) and had higher HrQoL (score 28±20 vs 36±22, OR 0.984, P-value=0.022). compared to patients with consistently poor self-care. The variance was explained by 20%. Conclusion Younger patients with HF tend to struggle with consistent self-care over a year, underscoring the necessity for tailored interventions for this group. Conversely, patients with greater HF knowledge and higher HrQoL maintained good self-care habits.

The relationship of diabetes knowledge and self-care practices among patients with type 2 diabetes mellitus

Background: Diabetes Mellitus (DM) is a disease characterized by increased blood glucose levels and cannot be cured so it requires self-care. DM self-care is a program that must be carried out throughout the life of DM sufferers. DM self-care aims to optimize metabolic control, optimize quality of life, and prevent acute and chronic complications. Good knowledge and self-care consisting of good diet, physical exercise, medication, and education can control blood sugar levels and prevent complications of type 2 DM. Purpose: To determine the relationship between knowledge and self-care in patients with type 2 diabetes mellitus. Method: Descriptive correlational research design with a cross-sectional approach. The study population was patients with type 2 diabetes mellitus in the work area of ​​the Pasar Rebo District Health Center, East Jakarta, totaling 690 patients, carried out in November-December 2023. The sampling technique used the Accidental Sampling technique with the Slovin formula and a sample of 87 respondents was obtained. The research instrument used the Diabetes Knowledge Questionnaire (DKQ-24) for the knowledge questionnaire and the Summary of Diabetes Self Care Activity (SDSCA) for the self-care questionnaire. Data analysis used the univariate and bivariate Chi Square alternative tests. Results: Respondents with poor knowledge resulted in poor self-care of 30 respondents (53.6%), while respondents with good knowledge resulted in good self-care of 16 respondents (51.6%). The results of the Chi-Square test showed a significant p value of 0.001 (<0.05). Conclusion: There is a significant relationship between knowledge and self-care in type 2 DM patients with a p value of 0.001.

Diabetes knowledge, health literacy and diabetes self-care among older adults living with diabetes in Alexandria, Egypt

BackgroundType 2 diabetes is a rising health problem, especially in older adults. Health literacy and the degree of diabetes knowledge are among the factors that may influence diabetes self-care activities. The aim of this study was to assess factors affecting self-care activities among older adults living with type 2 diabetes in Alexandria, Egypt.MethodsA cross-sectional study included 400 older adults over the age of 60 with type 2 diabetes, recruited from diabetes outpatient clinics affiliated to the health insurance organization in Alexandria, Egypt. A predesigned, structured interview questionnaire was used to assess sociodemographic factors, personal habits, medical history, and drug history. The All Aspects of Health Literacy Scale (AAHLS) and the numeracy section of the Short Test of Functional Health Literacy in Adults (STOFHLA) were used to assess the level of health literacy. Diabetes Knowledge Test 2 (DKT2) was used to assess diabetes knowledge and Summary of Diabetes Self-care Activities scale was used to assess self-care activities. Multiple logistic regression analysis was used to examine the relationship between health literacy and self-care.ResultsThe mean age of the participants was 65.75 ± 5.15 years, and 56.2% of them were males. The mean duration of diabetes was 10.61 ± 5.28 years, 14.3% were illiterate, and 37.2% were university graduates. Positive correlations were found between health literacy, diabetes knowledge, and diabetes self-care activities (p < 0.001). Health literacy and diabetes knowledge were found to be significant predictors of diabetes self-care activities in older adults (aOR = 1.132; 95% CI:1.062–1.207, p < 0.001 and aOR = 1.313; 95% CI: 1.178–1.464, p < 0.001; respectively).ConclusionsHealth literacy and diabetes knowledge were found to be predictors of good self-care activities in older adults living with diabetes. Health educators and health care professionals should focus on health education and the enhancement of diabetes knowledge to improve self-care activities and eventually glycemic control in older adults living with diabetes.

Self-care adherence and associated factors among hypertensive patients at Guraghe Zone, 2023

BackgroundHypertension is the primary cause of cardiovascular disease and early mortality. Self-care is important for the prevention of hypertensive-related complications, and it was found to be necessary to determine the self-care adherence of hypertensive patients in Guraghe Zone, as there are limited findings in this area. The other reason for conducting this study was that there are certain variables related to self-care that have not been well studied, such as BMI, the number of antihypertensive medications, and the duration of antihypertensive drugs the patients are taking. ObjectiveTo assess self-care adherence and associated factors among hypertensive patients at Guraghe zone public hospitals. Methods and materialsA multi-center institution-based cross-sectional study was conducted at selected Guraghe zone hospitals from May 20 to June 20, 2023. A systematic random sampling method was employed to select 370 participants. Hypertension self-care Activity Level Scale Effects (H-SCALE) was used to measure the self-care status. A binary logistic regression model was applied, and variables with a p-value <0.05 with a 95 % CI in the multivariable analysis were considered significant. ResultsThe study evaluated the self-care adherence of 370 patients, and 50.8 % of patients had good self-care adherence. Normal BMI (AOR = 2.049, 95 % CI: 1.041, 4.033), starting antihypertensive in <5 years (AOR = 2.530, 95 % CI: 1.462, 4.381), patients taking three or more antihypertensive (AOR = 4.534, 95 % CI: 2.005, 10.252), absence of comorbidity (AOR = 1.758, 95 % CI: 1.030, 3.003), and strong social support (AOR = 3.842, 95 % CI: 1.994, 7.402) were significantly associated with good self-care. Conclusionand recommendation: Nearly half of patients with hypertension had good self-care adherence. BMI, antihypertensive duration, number of antihypertensive, comorbidity, and social support were variables that showed significant association with self-care adherence. Patients need to implement the lifestyle recommendations in addition to regular follow-up to prevent complications. Health-care facilities need to provide health education on the proper implementation of self-care recommendations.

Nursing Agency in Improving Self Care Activities in Diabetes Mellitus Patients

Nurses are important role in motivating diabetes mellitus patients to be willing and able to carry out self-care independently at home to achieve good blood sugar control, prevent complications and improve quality of life. This research contributes to determining the development of self-care in diabetes mellitus patients and determine the role of nurses in providing a supportive education system, while the specific target to be achieved in this research is changes in good self-care for diabetes mellitus patients so that it can improve the quality of life and to encourage nurses to provide independent nursing care with a supportive education system to diabetes mellitus patients. This research method used quasi-experimental research design with a one group pretest-posttest approach. The population in this study was 32 respondents of diabetes mellitus patients at the Banyuurip health center. The sampling technique used a purposive sampling technique, namely sampling based on certain criteria. This research will be carried out at the Banyuurip Community Health Center, Purworejo Regency. The results of the paired t-test statistical analysis showed : p Value 0.000 &lt; 0.05, which shows that there is an influence of nursing agencies in increasing self-care activities for diabetes mellitus patients. Conclutions that Diabetes mellitus is a chronic disease that requires special independent management behavior throughout life. Through a good self-care approach, patients can improve blood sugar control and reduce the risk of future complications. Therefore, the role of health workers to provide education and support patients to improve self-care behavior is very important.

Gambaran Self-Care Pasien dengan Penyakit Jantung Koroner Pasca Kateterisasi Jantung

Coronary heart disease is one of the most common cardiovascular diseases throughout the world which results in high rates of mortality, morbidity and also has a financial impact. One of the main management for coronary heart disease patients is self-care. Several studies show that treatment outcomes for coronary heart patients are better in patients who engage in consistent self-care. Programs and guidelines regarding self-care for coronary heart patients have been proven to reduce rehospitalization rates. The results of other research show there is a link between a good quality of life and good self-care. The aim of this research is to determine the description of self-care for coronary heart patients after catheterization at the Integrated Heart Care Installation at Prof.Dr.I.G.N.G Ngoerah Hospital. This research uses a descriptive analytical design with a cross sectional approach using the SC-CHDI questionnaire. The total sample was 219 respondents using purposive sampling technique. The results of the study showed that 77,2% respondent have sufficient catagory, Self-Maintenance results for coronary heart patients at the Integrated Heart Care Installation at Prof. Dr. I. G. as many as 119 people (54,3%). Self-care-confidence was in the sufficient category, 195 respondents (89%) and the results of self-care management for coronary heart patients were in the sufficient category,115 respondents (52,5%). The description of self-care for coronary heart disease sufferers is influenced by respondent characteristics such as age, gender, education, occupation, and length of illness.

Gambaran perawatan diri pada pasien hipertensi di puskesmas Kalijati Subang

Hypertension is a non-communicable disease characterized by an increase in blood pressure above normal limits. Hypertension is a disease that increases every year and can cause complications. Hypertension can be prevented from complications by doing good self-care to control blood pressure. Self-care is an action taken independently to improve health, prevent disease and maintain health. Here are 5 components of self-care for people with hypertension, namely self-integration, self-regulation, interaction with health workers and others, monitoring blood pressure, and adherence to recommended rules. The purpose of this study was to determine the description of self-care in hypertensive patients at Puskesmas Kalijati Subang. This research design is descriptive with cross sectional design. The population in this study was 921 people, where the research sample was 91 people. The sampling technique used purposive sampling. The results of this study found that self-care in hypertensive patients at Kalijati Subang Health Center was 61.5% in the bad category and 38.5% in the good category. The conclusion is that most of the self-care in hypertensive patients at Puskesmas Kalijati Subang is in the bad category. It is hoped that future researchers can develop related factors that affect self-care in hypertensive patients.

Self-care behavior and associated factors among adult heart failure patients in outpatient cardiac follow-up unit at Wachemo University Nigist Eleni Comprehensive Specialized Hospital, Southern Ethiopia

BackgroundHeart failure is a serious medical condition that occurs when the heart is unable to pump sufficient blood to meet the needs of the tissues. Good self-care is an essential behavior in long term management and maintenance of physiologic stability, better medical and person-centered outcomes. Poor self-care behavior deteriorates the outcomes of heart failure patients. However, there were no sufficient evidences that illustrate the topic in the country, including the study area.MethodologyInstitutional based cross-sectional study was conducted among 250 heart failure patients from July 5-August 4, 2021. All adult heart failure patients who fulfill the inclusion criteria and have appointment during study period were included in the study. Interview and medical chart review was used to collect data. Epidata version 3.1 and SPSS version 20 were used for data entry and analysis respectively. Bivariate and multivariable analysis was computed. The model fitness was checked by Hosmer and Lemeshow test.ResultsFrom the total patients, 240 were interviewed with the response rate of 96%. Among these, 140(58.3%) [95% CI: 52.6, 64.9] had poor self-care behavior. Age>54: 9.891 [2.228, 43.922], poor knowledge: 6.980[1.065, 45.727], depression: 4.973[1.107, 22.338], low social support: 6.060[1.373, 26.739], insomnia: 4.801[1.019, 22.622] and duration with heart failure <1 year: 5.782[1.438, 23.247] were factors associated with poor self-care behavior.ConclusionIn this study, more than half of participants attending at Wachemo University Nigist Eleni Comprehensive Specialized Hospital in outpatient cardiac follow-up unit had poor self-care behavior. Of the study variables, older age, poor knowledge, depressive symptoms, low social support, insomnia and short duration with heart failure were related with poor self-care behavior. Thus, the findings highlight importance of assessing level of self-care behavior and implicate direction to take action to enhance level of self-care behavior.

Influence of Family Function on Self-care Practice among Type 2 Diabetes Patients in a Primary Care Clinic in Northern Nigeria

Abstract Context: Family function and self-care practices are important components of type 2 diabetes (T2DM) care to achieve good glycemic control, promote health, and prevent the early onset of complications. Aim: To determine the influence of perceived family functionality on the self-care practice of T2DM patients. Setting and Design: A cross-sectional study involving 241 patients aged ≥18 years who presented at the family medicine clinic. Methods and Materials: The family function was assessed using the family APGAR tool, while self-care practice was assessed using the Summary of Diabetes Self-Care Assessment tool. Statistical Analysis: The Chi-square test and logistic regression analysis were used to determine the relationship between variables, self-care practice, and the determinants of self-care practice, respectively. Results: The mean age of the respondents was 56.6 ± 11.1 years; 161 (66.8%) were females. The proportion of those with highly functional families was 56%, while the prevalence of good self-care practices was 17.8%. Irregular clinic attendance (OR = 0.434, 95%CI = 0.23-0.82, P ≤ 0.001), BMI [underweight (OR = 9.325, CI = 1.635 – 53.182, P = 0.01), normal (OR = 2.729, CI = 1.203 – 6.188, P = 0.02)], good glycemic control (OR = 2.9, 95%CI = 1.48-5.80, P = 0.002), and moderately dysfunctional family (OR = 0.418, 95%CI = 0.19-0.93, P = 0.03) were the determinants of self-care practice among T2DM. Conclusion: The prevalence of highly functional families was high but with a very low level of self-care practice. Clinic attendance, BMI, good glycemic control, and family function were the determinants of self-care practice.

IJCM_130A: Self-care practices and its determinants among type 2 diabetics- A cross sectional study

Background: Self-care practices that include self-monitoring of blood sugar level, diet management, physical exercise, adherence to medications, and foot care are the cornerstones of diabetes management. Objective: To assess the self-care practices and factors associated with it among type 2 diabetics Methodology: A community-based cross-sectional study was conducted among the 150 known diabetics in a urban PHC between July 2023 and September 2023. Self-care practices among the registered diabetes patients were described in seven domains as recommended by the American Association of Diabetes Educators (AADE). Risk factors were identified using univariate, followed by multivariate logistic regression. The risk for poor self-care score was expressed in odds ratio (OR) with 95% confidence interval (CI) Results: The mean age of the participants was 57 years (SD: 9.5 years). The self-care was prominent in diet modification, physical activity, and physical activity components. The median self-care score of the participants was 14 (IQR = 12.5 to 15.5). Out of 150 diabetic patients studied, about 48 (32%) participants have good self-care scores, 96 (64%) participants have moderate self-care scores and only 6 (4%) participants have poor self- care scores. Conclusion: Our study emphasized on the need for knowledge and awareness to be provided in urban areas regarding diabetes care management and self- care practices. Structured programs need to be planned to improve the attitude and practices of diabetic patients to promote better compliance towards diet, exercise, adherence to drugs, and appropriate foot care.

ANALISA PERSEPSI TERHADAP SELF CARE SKILLS PADA PASIEN DM TIPE II PADA MASYARAKAT PERKOTAAN

Assessment of the impacts of urban change at the neighborhood level provides a unique opportunity to generate insights into the extent and nature of positive and negative impacts on health-related outcomes. Several specific components and mechanisms that cause urban change can influence behavior, perception and self-care, thereby impacting health. The high prevalence of non-communicable diseases, one of which is Type 2 Diabetes Mellitus. Type 2 Diabetes Mellitus occurs when the body stops producing sufficient amounts of insulin, or when the body does not use insulin properly (something known as insulin resistance). in 2021 in the Jember urban area it will reach 1,700, one of which is due to lifestyle factors in the urban environment. One strategy for dealing with type 2 diabetes mellitus is to optimize the prevention of type 2 diabetes and associated comorbidities with a therapeutic approach, one of which is optimizing self-care which can reduce complications, reduce cardiovascular and kidney risks, and improve health outcomes. The aim of this research was to determine the relationship between disease perception and the self-care skills of type II diabetes mellitus patients. This research used a cross sectional method with a total of 100 respondents, data collection used a disease perception questionnaire and a quality of life questionnaire which were given to respondents directly. The results of the chi square test research obtained a value of p = 0.030 or &lt; (0.05), so Ha was accepted, meaning that there was a relationship between disease perception and the quality of life of type II diabetes mellitus patients. The conclusion obtained from this research is that there is a relationship between perception of illness and self-care skills. The increase in good self-care skills is due to good perception.. Keywords: Perception, Self Care Skills, Urban Society, Diabetes Mellitus

Reported self-care practice toward prevention of puerperal sepsis and associated factors among postnatal mothers: Community-based cross-sectional study.

Puerperal sepsis is a leading cause of maternal morbidity and mortality in low-income countries, which can affect sustainable development goals. Even though it is a preventable problem through maternal self-care practices, maternal-reported self-care practices regarding puerperal sepsis were under-researched in Ethiopia. Therefore, this study aimed to assess the maternal reported self-care practice and associated factors among postnatal mothers for the prevention of puerperal sepsis. The study aimed to assess the reported self-care practice of postnatal mothers in Arba Minch town toward the prevention of puerperal sepsis and its associated factors. A community-based cross-sectional study was employed from 1st to 30th May 2022. Study participants were selected using a simple random sampling technique. Data was collected by the Open Data Kit tool and exported to SPSS version 26 for further analysis. Both crude and adjusted odds ratios with a 95% CI were calculated, and a p-value of less than 0.05 was used to declare statistically significant factors. Of a total of 423 postpartum mothers, 417 participated, making a response rate of 98.5%. The study revealed that 45.6% (95% CI: 41.2%, 50.1%) of postnatal mothers had good reported self-care practices toward the prevention of puerperal sepsis. Tertiary educational level (AOR: 2.56; 95% CI: 1.43, 4.59), multiparity (AOR: 0.44; 95% CI: 0.26, 0.74), and having a good awareness of puerperal sepsis prevention (AOR: 2.17; 95% CI: 1.40, 3.37) were significantly associated at a p-value less than 0.05. This study revealed that less than half of postnatal mothers reported good self-care practices. Healthcare providers and all stakeholders should focus on strategies to improve self-care practice during antenatal and postnatal care and at a community level, with a special focus on postnatal mothers with no formal education and multiparous mothers.

Adherence to Self-care Practices among Type 2 Diabetes Mellitus Patients in Rural Area of Tamil Nadu, India: A Cross-sectional Study

Introduction: Developing countries like India are facing an increased threat from both non communicable and communicable diseases. The prevalence of Type 2 Diabetes Mellitus (DM) among non communicable diseases has been rapidly increasing in India. The complications of diabetes, including both acute and chronic effects, impact the physical, mental, and social well being of patients. The effectiveness of diabetes management solely depends on the self-care practices adopted by individuals and their family members. Aim: To evaluate the patterns of self-care practices among diabetic patients and the factors associated with them. Materials and Methods: A community-based cross-sectional study was carried out among 206 diabetic patients in and around the rural field practice area of ACS Medical College and Hospital in Thiruvallur district, Chennai, Tamil Nadu, India, from June 2022 to November 2022. Type 2 DM patients aged ≥18 years were included in the study. The participants were interviewed about their diabetic status and various parameters of self-care practices, using the Summary of Diabetes Self-care Activities (SDSCA) score. The Chi-square test was applied to assess the relationship between self-care practices and factors such as age and gender. Results: The mean age of the participants was 47±10 years. The present study observed that the overall prevalence of poor selfcare practices was low, with 92 participants (44.7%) exhibiting poor practices and 114 participants (55.3%) demonstrating good self-care practices. In the current study, the association between self-care activities and education level, as well as the clinical profile of the patients, was statistically significant. A negative linear correlation was found between self-care practice scores and blood glucose levels. Conclusion: Self-care behaviours among diabetes patients were found to be good in more than half of the study population. These behaviours were significantly associated with age, education level, and complications of diabetes. The results emphasise the complex nature of self-care behaviours among individuals with DM and highlight the necessity for customised therapies that target individual challenges and foster supportive environments.

Exploring the association between self-care behaviour, knowledge and cognition in patients with heart failure: a secondary analysis from the HF-Wii study

Abstract Background Self-care is vital for patients with heart failure and is influenced by different factors, Knowledge and the ability to reflect on behaviors is important to make decisions on self-care. Cognition may also be an important factor in relation to both knowledge and self-care. It has been found that cognitive impairment in patients with heart failure is common, with a reported prevalence of 20–80%. Aim To explore association between self-care behaviour, knowledge and cognition in patients with heart failure. Methods This is a secondary analysis of the baseline measures from the HF-Wii study with data from 605 patients, mean age 70 ± 12, 29% female, 30 % in New York Heart Association Class III-IV. Data on self-care was collected with European Self-care Behaviour Scale (EHFScBS) (possible range 0-100). Knowledge was collected with the Dutch HF Knowledge Scale (possible range 0-15 points). Cognition was assessed Montreal Cognitive Assessment (MoCA). Knowledge was dichotomised into low vs. high knowledge (cut off 13) and cognition into mild, moderate or severe cognitive problems vs. no or light cognitive problems. Results The total score on the EHFScBS was 64.6 ± 21.0 with 41% (N=245) of the patients performing good self-care (score &amp;gt; 70). The mean score on the Dutch HF Knowledge Scale was 12.3 ± 1.9 and 308 patients had high knowledge (score &amp;gt; 13). The majority of the patients (61%; N=371) had mild cognitive problems and 195 (32%) had no or light cognitive problems with a mean MOCA score of 24.4 ± 3.8. Self-care was significantly correlated to total knowledge (r = .23; p &amp;lt; .001), but it was not correlated to cognition. Furthermore, there was a positive correlation between total knowledge and cognition (r = .43; p &amp;lt;.001). Out of the 308 patients with high level of knowledge (&amp;gt;13), 130 had mild, moderate or severe cognitive problems. The other 178 patients with high knowledge had no or only light cognitive problems. Patients with high knowledge had a significantly higher score on the self-care behavior scale, independently of their cognitive function. In a multivariable logistic regression analysis, higher age [odds ratio (OR) 1.03; 95% confidence interval (CI) 1.02-1.06), better quality of life (OR .95; 95% CI .90 - .99) and higher levels of knowledge (OR 1.25; OR 1.13 – 1.38) were independently related to self-care. Conclusion HF knowledge and cognition are related in patients with heart failure, but only knowledge, not cognition, was independently related to self-care.

Re-admission and quality of life among patients with chronic obstructive pulmonary disease after telemedicine video nursing consultation - a randomized study.

Our previous study showed a reduced cumulative length of re-admission stays due to chronic obstructive pulmonary disease (COPD) exacerbations during one year after telemedicine video consultation (TVC). The current study evaluated the effects of TVC on the length of re-admission stays within 12 months follow up post-TVC compared to phone call follow up or COPD usual care in a randomized study. Our secondary aim was to assess the impact of TVC on the frequency of re-admissions within 12 months of follow up. Patient satisfaction, hospital anxiety and depression scale (HADS) and COPD assessment test (CAT) scores were also evaluated. The study was a prospective randomized study of COPD patients who after hospital discharge for acute COPD exacerbations, were randomized to monitoring by TVC at home compared to phone call follow up for two weeks by a specialist nurse at the hospital or usual COPD care. Prospectively, we compared the cumulative durations and frequencies of hospital re-admissions due to COPD exacerbations within 12 months follow up after TVC, phone call follow up or usual COPD care. Among 173 COPD patients followed for 12 months, 99 were re-admitted. The median cumulative length of readmission stays per patient within 12 months post-TVC did not differ from those followed by phone calls or with usual COPD care. The number of patients re-admitted and the number of re-admissions due to COPD exacerbations were also equal in the three groups. Patient satisfaction was high among those followed by TVC and phone calls, and the HADS and CAT scores favorably declined from baseline to post-intervention in patients followed by TVC and phone calls. The study could not demonstrate a beneficial effect of TVC on the cumulative length of re-admission stays or on the number of re-admissions within 12 months following an acute COPD hospital stay, as compared to those followed by phone calls or with usual COPD care. Patient satisfaction was high among those followed by TVC and phone calls, and the declines in HADS and CAT scores seem to be consequences of increased empowerment and competence for good self-care in COPD patients, remaining through the one-year observation period.

Factors Associated with Anxiety and its Self-Care Measures among Nursing Students During the Covid-19 Pandemic

Introduction: One of the rising mental health issues among university students during the COVID-19 pandemic is anxiety. As future healthcare front-liners, nursing students are expected to perform good self-care to deliver quality care to patients. The purpose of the present study is to examine the factors associated with anxiety and its’ self-care measures among nursing students. Methods: The study recruited over 200 students in the East Coast region of Malaysia and the online survey was conducted during the COVID-19 pandemic between December 2020 and January 2021. The questions were in 3 parts: Socio-demographic, Self-care assessment worksheet (SCAW), and Burns Anxiety Inventory. Descriptive statistics, correlational analysis, and multiple linear regression were used to answer the research aim. Results: The range of anxiety levels among the nursing students was from no anxiety (7.5%) to severe anxiety or panic (28.9%, 17.9%). Multiple linear regression analysis revealed two predictors associated with higher level of anxiety were the first-year nursing students (bb =10.90, CI=4.49, 17.30), and respondents who stated having fairly satisfied with the nursing program (bb =13.50, CI=5.10, 21.90). Among the self-care components, result revealed that higher levels of physical care throughout the semester predicted lower anxiety (bb =-0.85, CI=-1.328, -0.372, p&lt;0.05). Conclusion: The study’s overall finding is that nursing students’ participation in self-care, particularly physical care, may help to lessen anxiety. Our findings are significant because self-care can complement psychiatric interventions for people with high levels of anxiety and is a significant contributor to mental well-being.

The Flow of Social Environmental Determinants of Disabilities on Lepers in Tuban City

Background: Leprosy is a neglected tropical disease considered rare in most areas despite having a relatively high incidence in some countries. Objective: Analyze the flow of determinants of the social environment that can affect the occurrence of disability in lepers and their impacts. Method: Research using a qualitative approach. The research was conducted in Tuban Regency, East Java Province. The informant selection technique uses a purposeful sampling technique. Data analysis uses triangulation techniques. Results: The frequency of leprosy in Tuban Regency tended to decrease from 2014-2019. Leprosy distribution occurred in 18 sub-districts; Lepers were found every month in 2019 with various characteristics of lepers that cause the emergence of leprosy and disability in leprosy. The total number of informants in this study was seven informants. Determinants of disability in lepers include informant characteristics and social environment, including knowledge, contact history, family support, self-confidence, and impact. Conclusion: In this study, the social environment that most impact the occurrence of disability in lepers is the informant knowledge factor. Informant knowledge is influenced by education, a large network of friends, and technological literacy. Education will show the type of informant work, and the type of work will determine the income of the informant; income determines economic status. Economic status contributes to food intake, medication seeking, and the home's physical condition. The duration of leprosy treatment will affect the worsening of the disability if good self-care is not carried out and always use PPE when doing activities.

Self-Reported Treatment Adherence in Patients of Diabetes Mellitus Type 2: A Cross-Sectional Study in Lahore, Pakistan

Objectives: Suboptimal adherence to therapy due to neglected self-care behavior in chronic diseases is a global crisis. The aim of this research was to gauge the prevalence of adherence and to assess the effect of age, sex, education level and socioeconomic status on adherence to self-care strategies. Methods: A cross-sectional study was conducted at Diabetes Management Centre, Services Hospital Lahore. 357 patients were administered a standardized questionnaire, the Diabetes Self-Management Questionnaire. A cut off value of 7 on a 0-10 scale was labeled as good adherence. The influence of age, sex, education and income on adherence was examined by multiple logistic regression analysis.

Self-Care Practices in Diabetes

Background: Self-care practices in diabetes are deemed as one of the mainstays of management, but often poorly practiced by people with diabetes. Aim: The study describes self-care practices among adult diabetics registered with a primary health-care setup. Methods: This was a community-based cross-sectional study based out of the Ramaiahguda primary health center in Vikarabad town of Telangana. Informed consent was taken from all participants before the commencement of the study. All eligible candidates were approached for the study. The seven domains of the “American Association of Diabetes Educators measures of outcome” were taken as the base for assessment of self-care practices among the participants. Results: The mean (standard deviation [SD]) age of the 155 study participants was 50.8 years (SD 12.4 years). Among the various components of self-care, drug adherence, glucose monitoring, and diet modifications were regular as per the advice. Comparatively, healthy coping, risk reduction, and problem solving are the areas where the participants had a major scope to improve. The median self-care score of the participants was 15.25 (interquartile range 14.5–16.25) ranging from 0.25 to 18.0. 86 (55.5%) participants had good self-care scores, and 69 (44.5%) participants had moderate self-care scores. Conclusions: The observations from our study point toward a lack of understanding and in-depth evaluation of the effectiveness of diabetic self-care practices, which may in turn be one of the factors affecting compliance to such practices among the diseased population.

Self- Efficacy and Self- Care Practices, In Glycemic Control among Adults with Diabetes Mellitus Receiving Care at Kitwe Teaching Hospital, Ktiwe, Zambia

Diabetes mellitus is a major public health problem that is approaching epidemic proportions worldwide. Uncontrolled disease can lead to complications which can eventually result in reduced life expectancy and major health cost. Glucose control is fundamental in delaying the onset of complications as such patients are required to practice regular self-care in order to achieve optimal blood glucose levels and prevent complications. Higher self-efficacy has been shown to contribute to improved self-care behaviour and better glycaemic control. The study therefore sought to evaluate the relationship between self- efficacy and self- care practices, in glycemic control among adults with diabetes mellitus, receiving care at Kitwe Teaching Hospital, Zambia. A cross sectional correlational study design was utilized. A total of 112 patients participated in a study. They were selected using a simple random sampling method. A structured interview schedule was used to collect data on self-care practice. Self-efficacy was measured using a modified Diabetes Self-efficacy Scale and glycemic control was obtained by calculating the average of three consecutive fasting blood sugar results. Data was entered and analyzed using the Statistical Package for Social Sciences (SPSS) for Windows version 25.0. The Chi-square and Fisher’s exact tests were used to test the associations between variables. The Binary logisticregression was used to determine the true predictor variables to glycemic control. The study results showed that more than three quarters (79.4%) of the participants had poor glycemic control, more than half (61.6%) of the participants had high self-efficacy and about two thirds (66%) of the participants practiced good self-care. The study results showed a statically significant relationship between glycaemic control and self-efficacy p&lt;0.001. The finding of the binary logistic regression analysis was statistically significant (p&lt;0.01) as it showed that patients who practiced good self-care had 6.64 times greater odds of glycaemic control (OR: 6.64, CI: .46, .88). There is, therefore, need to strengthen the educational programs with emphasis on selfcare activities to help achieve normal glycaemic levels. Self-efficacy should also be incorporated in the diabetic treatment protocols as it enhances self-care practice.